Book contents
- Clinical Ethics in Anesthesiology
- Clinical Ethics in Anesthesiology
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- 1 Consent and refusal
- 2 End-of-life issues
- 15 The principle of double effect in palliative care: euthanasia by another name?
- 16 Surgical interventions near the end of life: “therapeutic trials”
- 17 Withholding and withdrawing life support in the intensive care unit
- 18 Discontinuing pacemakers, ventricular assist devices, and implanted cardioverter-defibrillators in end-of-life care
- 19 Brain death
- 20 Ethical issues in organ donation after cardiac death
- 21 Revising the Uniform Anatomical Gift Act – the role of physicians in shaping legislation
- 22 Physician aid-in-dying and euthanasia
- 3 Pain management
- 4 Research and publication
- 5 Practice issues
- 6 Anesthesiologists, the state, and society
- Index
16 - Surgical interventions near the end of life: “therapeutic trials”
from 2 - End-of-life issues
Published online by Cambridge University Press: 05 March 2012
Book contents
- Clinical Ethics in Anesthesiology
- Clinical Ethics in Anesthesiology
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- 1 Consent and refusal
- 2 End-of-life issues
- 15 The principle of double effect in palliative care: euthanasia by another name?
- 16 Surgical interventions near the end of life: “therapeutic trials”
- 17 Withholding and withdrawing life support in the intensive care unit
- 18 Discontinuing pacemakers, ventricular assist devices, and implanted cardioverter-defibrillators in end-of-life care
- 19 Brain death
- 20 Ethical issues in organ donation after cardiac death
- 21 Revising the Uniform Anatomical Gift Act – the role of physicians in shaping legislation
- 22 Physician aid-in-dying and euthanasia
- 3 Pain management
- 4 Research and publication
- 5 Practice issues
- 6 Anesthesiologists, the state, and society
- Index
Summary
This chapter presents a case study on an 86-year-old retired accountant, experiencing worsening symptoms and signs of congestive heart failure. The patient clearly understood and accepted the balance of benefits versus risks, and gave informed consent to the procedure. Offering the operation is respectful of the ethical principle of autonomy. The patient's primary goals were to improve his functionality and reduce his symptoms even with a substantial risk of dying. The chapter discusses questions that need to be addressed when the outcome of the intervention is poor and the possibilities of achieving the patient's stated goals are virtually nil. The focus should be on the overall trend and not the minor ups and downs of vital signs, drug infusion rates, ventilatory settings, etc. It is important to recognize that it will take time, perhaps days, for the family to grasp the lack of improvement or deterioration in the patient's condition.
Keywords
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- Information
- Clinical Ethics in AnesthesiologyA Case-Based Textbook, pp. 92 - 96Publisher: Cambridge University PressPrint publication year: 2010